Sex between men has been recorded in almost every human society and at every stage in history. At some times and some places it is accepted; more often than not it is repressed or even denied. In certain cultures, homosexual behaviour may be condemned among adults but permitted as play between adolescent boys, or men may have discreet relationships with other men so long as they also marry and have children.
Studies confirm that boys and men across the world report sex with other boys and men, with rates of 10-16% in Peru, 5-13% in Brazil, 10-14% in the US, 15% in Botswana and 6-16% in Thailand. Some men may identify themselves as "homosexual" or "gay" (specific terms exist in almost all cultures) and have long-term or occasional sexual relationships with other men. Others may be married or in a long-term relationship with a woman and occasionally have sex with men, often without their female partner knowing. In yet other cases, sex may take place between men because they are the only sex partners available, as in the case of men in prison or in all-male institutions.
In many parts of the world men who have sex with men are frequently the target of prejudice and discrimination, even legal sanction. This social stigma has prevented many men and boys from admitting that they are at risk of contracting HIV from sex with other men and has prevented the development of HIV prevention campaigns directed at those men at risk. Negative social attitudes often lead to stress for men who see themselves as homosexual; an Australian study found that around 28% of young men who preferred sex with other men had attempted suicide, compared with under 8% of heterosexual young men.
Anal intercourse is often a component of sex between men and is practised by 30-80% of men according to surveys from various settings. Because of increased friction and the fragile tissues in the anus, anal intercourse involves a higher risk of HIV transmission than vaginal intercourse, particularly for the receptive partner. The consistent and correct use of condoms, properly lubricated, is thus crucial for HIV prevention.
Since the beginning of the AIDS epidemic, community groups and other NGOs made up of men who have sex with men have engaged in prevention and care. In some countries, homosexual men started the first support organizations for people with AIDS, in the absence of action by governments and traditional NGOs. As one example, the Naz Foundation developed the first clinical services and outreach for men who have sex with men in New Delhi, India, offering education, information, testing and treatment for sexually transmitted infections (STIs), HIV testing and counselling, support groups for HIV-positive men and a telephone hotline.
Efforts by NGOs working with men who have sex with men have often been limited in scope and in some cases constrained by repressive legislation and discriminatory attitudes. Most receive little financial or political support from government -- constraints which must be tackled if countries are to mount more effective prevention of HIV transmission through sex between men.
This article was provided by UNAIDS. It is a part of the publication Men and AIDS -- A Gendered Approach, 2000 World AIDS Campaign. Visit UNAIDS' website to find out more about their activities, publications and services.